| Mediserv | |
|
3137 Pine Orchard Ln Apt 202 Ellicott City MD 21042-4263 | |
| (443) 418-9957 | |
| Not Available |
| Full Name | Mediserv |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3137 Pine Orchard Ln Apt 202, Ellicott City, Maryland |
| Authorized Official Name and Position | Marsha P Holevas (OWNER) |
| Authorized Official Contact | 4434189957 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mediserv 3137 Pine Orchard Ln Apt 202 Ellicott City MD 21042-4263 Ph: (443) 418-9957 | Mediserv 3137 Pine Orchard Ln Apt 202 Ellicott City MD 21042-4263 Ph: (443) 418-9957 |
| NPI Number | 1164189866 |
|---|---|
| Provider Enumeration Date | 11/17/2021 |
| Last Update Date | 11/22/2021 |
| Certification Date | 11/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164189866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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